CPHON Pediatric Hematology Oncology Nurse 4

Question 1

A child with newly diagnosed AML is found to have a WBC of 120,000/mm³. The nurse anticipates which emergent complication?

Accepted Answer

Leukostasis causing pulmonary and CNS symptoms

Answer

Extreme leukocytosis (hyperleukocytosis) in AML causes leukostasis, where blast cells obstruct microvasculature in the lungs and brain.

Question 2

Which late effect is most commonly associated with anthracycline chemotherapy in pediatric cancer survivors?

Accepted Answer

Cardiomyopathy and congestive heart failure

Answer

Anthracyclines (doxorubicin, daunorubicin) cause cumulative cardiotoxicity leading to cardiomyopathy, which may appear years after treatment.

Question 3

A nurse is educating the family of a child with febrile neutropenia. Which statement by the parent indicates a need for further teaching?

Accepted Answer

'I will give acetaminophen to mask the fever and monitor at home for 24 hours before calling.'

Answer

Parents must not delay seeking care for fever during neutropenia; delaying evaluation can allow a bacterial infection to progress to sepsis rapidly.

Question 4

A pediatric patient is receiving radiation to the spine for medulloblastoma. Which side effect should the nurse anticipate months after therapy?

Accepted Answer

Growth retardation due to vertebral growth plate damage

Answer

Spinal radiation in children damages vertebral growth plates, leading to impaired spinal growth and short stature as a late effect.

Question 5

Which assessment finding is an early sign of superior vena cava (SVC) syndrome in a child with a mediastinal tumor?

Accepted Answer

Facial edema and plethora that worsens when leaning forward

Answer

SVC syndrome causes venous congestion above the obstruction, presenting with facial and upper extremity swelling and plethora, worsened by gravity.

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